Healthcare Provider Details

I. General information

NPI: 1376835819
Provider Name (Legal Business Name): NYCHHC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2011
Last Update Date: 05/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 1ST AVE
NEW YORK NY
10029-7404
US

IV. Provider business mailing address

1901 1ST AVE
NEW YORK NY
10029-7404
US

V. Phone/Fax

Practice location:
  • Phone: 212-423-7109
  • Fax: 212-423-7024
Mailing address:
  • Phone: 212-423-7109
  • Fax: 212-423-7024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number075938
License Number StateNY

VIII. Authorized Official

Name: MS. MERYL WEINBERG
Title or Position: EXECUTIVE DIRECTOR
Credential: RN
Phone: 212-423-6262